
<form id="form1" method="post" style="margin:10px;">
	<input type="hidden" name="ID" id="ID" value="<?=$ID?>">
	<input type="hidden" name="ID_KPS" id="ID_KPS" value="<?=$ID_KPS?>">
	<div class="fitem" >
		<label style="width:150px">Nama KKKS </label>:
		<select id="ID_KPS" name="ID_KPS" style="width:200px;" <?php if($aksi == 'edit'){echo 'disabled';}?>>
			<?=$this->prosedur_model->OptionNamaKKKS(array('value'=>$ID_KPS));?>
		</select>
	</div>
	<div class="fitem" >
		<label style="width:150px;">Bulan </label>:
			<select id="BULAN" name="BULAN" style="width:200px;">
					<?=$this->prosedur_model->OptionNamaBulan(array('value'=>$BULAN));?>
			</select>				
	</div>	
	<div class="fitem" >
		<label style="width:150px">Tahun </label>:
			<input name="TAHUN" size="10" maxlength="4" required="true" value="<?=$TAHUN?>">
		</select>

	</div>
	<div class="fitem">
		<label style="width:150px">Tanggal Nominasi  </label>:
		<input class="easyui-datebox" name="TANGGAL" size="13" value="<?=$TANGGAL?>" id="TANGGAL" data-options="formatter:DateFormatter, parser:DateParser">
	</div>
	<div class="fitem" >
		<label style="width:150px">Nominasi </label>:
		<input name="NOMINASI" size="20" required="true" value="<?=$NOMINASI?>">
	</div>
	
</form>
	

